【摘要】 目的　观察雷公藤甲素对糖皮质激素抵抗型 (SR)支气管哮喘 (哮喘 )患者血清细胞因子水平、哮喘症状和肺功能的影响 ,探讨雷公藤甲素对SR哮喘有无治疗作用。方法　SR哮喘患者 16例 ,随机分组为A、B 2组 ,每组各8例。 2组患者均予口服丙卡特罗 5 0～ 10 0 μg/d和茶碱 4 0 0mg/d ,并急性发作时吸入沙丁胺醇 2 0 0～ 80 0 μg/d。A组患者同时联合应用雷公藤甲素 33μg/次 ,口服 ,每日 3次。疗程 4周。疗程开始及结束时分别行血清干扰素 (IFN) γ、白细胞介素 (IL) 4、IL 5水平测定 ,哮喘临床积分和肺功能检查。结果　治疗后 ,A组患者血清IFN γ和肺功能指标用力肺活量 (FVC % )、第 1秒钟用力呼气容积 (FEV1% )、最大呼气流量 (PEF % )、5 0 %肺活量时最大呼气流量( V50 % )、2 5 %肺活量时最大呼气流量 ( V2 5% )均显著增高 ,哮喘临床积分和血清IL 4、IL 5显著降低 (与A组治疗前比较P <0 .0 1;与B组治疗后比较P <0 .0 5 )。B组治疗后与治疗前比较 ,上述各项指标均无显著改变 (P >0 .0 5 )。结论　雷公藤甲素是治疗SR哮喘的有效选择。更多还原

【Abstract】 Objective To investigate the effect of triptolide on the treatment of steroid-resistant asthma,the impact of triptolide on symptoms,serum cytokines and lung function of patients with steroid-resistant asthma was evaluated.Methods Sixteen patients with steroid-resistant asthma had been assigned to group A or B,8 patients per group.The patients in both groups received procaterol (50-100 μg/d) and theophylline(400 mg/d)orally,and inhaled salbutamol (200-800 μg/d) on acute occasions.Additionally,patients in group A received triptolide (33 μg a time,orally,three times a day,for 4 weeks).Asthmatic symptoms score,serum interferon gamma (IFN-γ),interleukin (IL)-4,IL-5 and lung function were measured at the beginning and at the end of the study.Results In group A,serum IFN-γ,indices of lung function forced vital capacity(FVC%),forced expiratory volume in one second(FEV 1%),peak expiratory flow(PEF%),maximal expiratory flow in 50%,vital capacity( 50%),maximal expiratory flow in 25% vital capacity( 25%), increased significantly,meanwhile,asthmatic symptoms score and serum IL-4,IL-5 decreased significantly (P< 0.01 comparing with group A before the treatment; P< 0.05 comparing with group B after the treatment).In group B,no significant change in all the indices had been observed after the treatment.Conclusion Triptolide may serve as an effective option for the treatment of steroid-resistant asthma.更多还原